Individual provider Active NPI

My Yang, DDS

  • Dentist
  • Elk Grove Village, IL
National Provider Identifier
1629439237
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.031514 Issued in IL
Practice address
834 S Arlington Heights Rd
Elk Grove Village, IL 60007-3667
Phone
(847) 439-2223
NPI assigned
Mar 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 019.031514 IL Primary

Addresses

Primary practice location

834 S Arlington Heights Rd
Elk Grove Village, IL 60007-3667

Mailing address

834 S Arlington Heights Rd
Elk Grove Village, IL 60007-3667
Phone (847) 439-2223

Other practice location 1

5301 Dempster St Ste 201
Skokie, IL 60077
Phone (847) 965-8780

Other practice location 2

2700 Martin Luther King Jr Blvd
Detroit, MI 48208
Phone (313) 494-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.031514ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mcy Dental PLLC CurrentSince Oct 30, 2022 Accepting new patients
Kushner Becker and Associates LTD PastSince Oct 30, 2022 Accepting new patients

Locations

4863A N Broadway St
Chicago, IL 60640
Phone (773) 506-7887

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1629439237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 S ARLINGTON HEIGHTS RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073667",
            "telephone_number": "847-439-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 S ARLINGTON HEIGHTS RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073667",
            "telephone_number": "847-439-2223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 Dempster St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "60077",
            "country_code": "US",
            "telephone_number": "847-965-8780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2700 Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48208",
            "country_code": "US",
            "telephone_number": "313-494-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "MY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-09",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.